Literature Review

Where do unhoused people go to die? The Denver Clarion, Denver, CO; by Hawke Baldwin; 5/4/26 ... On April 29th 9News presented its documentary “Refuge” in DU’s Anderson Academic Commons, giving viewers a glimpse into the reality of death. “Refuge” is a sad yet inspiring story that delves into end-of-life care for those both terminally ill and unhoused in Denver. ... A person featured in the film is James Patrick Hall, a Gregorian Frier and former engineer who founded Rocky Mountain Refuge, a haven for those in need of end-of-life care. The refuge is a hospice center providing home-style care for free. ... The documentary follows four unhoused and terminally ill individuals: Jennifer, Renne, James and Jose. All of whom were unable to find appropriate care anywhere else, so they turned to Rocky Mountain Refuge.

End-of-life doctors reveal 5 common fears people face in their final moments SavingAdvice.com; by Amanda Blankenship; 5/3/26  Most people avoid thinking about death, but doctors who work in hospice and palliative care say the same fears come up again and again. ... Research shows that death anxiety is common, with many people experiencing fear tied to the process of dying, not just death itself. ... here are five of the most common fears [identified by these doctors] among people facing their final moments.

Assessment of survival and the decision to engage in palliative care when facing a defeat in the ICUMedical Decision Making; by Hossam Gad, Daniel Diedrich, and Krzysztof Laudanski; 4/24/26 Highlights

[Singapore] Factors associated with caregiver burden among family caregivers of patients on home-based palliative care: A systematic reviewPalliative Medicine; by Wei-Ling Koh, Jerrald Lau, Chermaine Ang, Choon Meng Yee, Sara Ho, Ker-Kan Tan; 4/26Home hospice services are increasingly central to palliative care as more patients express preference for care or death at home. In these settings, the role of family caregivers becomes crucial.  Heterogeneity across studies highlighted uniqueness of patient-caregiver dyads on caregiver burden - for instance, family caregivers with multiple social roles may face heightened pressure from meeting patients' care demands. Other factors include logistical, financial or care arrangement matters. Caregiver burden interventions should adopt multi-pronged approaches to ensure holistic support for patients and family caregivers, such as incorporating both medical and psychosocial support to enhance wellbeing of both parties.

Unity receives $10,000 grant from the Door County Community Foundation The Chamber Manitowoc County, De Pere, WI; Press Release; 4/28/26 Unity is pleased to announce $10,000 in funding from The Door County Community Foundation on behalf of Bargains Unlimited Charitable Fund and Growing Older Fund to cover costs related to Unity’s palliative program, Supportive Care Management (SCM). As identified through Discuss Door County and reported in the 2023 American Community Survey Demographic and Housing Estimates, Door County is one of the oldest counties in Wisconsin, with 41% of residents age 60 or older and projections approaching 50% by 2030. 

Hope, uncertainty, and hard truths: the complexity of goals-of-care discussions in oncology OncLive - Oncology Live; by Maurie Markman, MD; 4/10/26 ... While appreciating considerable variation in how individuals deal with their [cancer] diagnosis, as well as understanding the potential for difficult conversations regarding the specifics of available therapeutic options and anticipated statistically defined survival, it remains essential that such discussions be held. ... What is the most appropriate conclusion regarding a goals-of-care discussion? Should this patient have been offered further testing and therapy, or, based on the facts of this case, was hospice referral perhaps a more reasonable suggestion?

Researchers at University of Pittsburgh target managed care (The state of hospice: Impacts on equity, quality, and nursing-an AAN consensus paper): managed care Insurance Newsnet; by a news reporter-staff news editor at Insurance Daily News; 4/24/26 ... This consensus paper examines the current state of hospice care in the US and the impact of changing hospice business models on health equity, healthcare quality, and nursing practice. Review of current literature and government policy statements related to hospice care and payment. Recommendations include updating policies to account for private equity involvement, evaluating current quality measures, addressing the existing Medicare Hospice Benefit, ensuring transparency and oversight for hospice agencies, and ensuring patient and caregiver education about hospice services.

[Canada] Palliative Care Coalition of Canada (PCCC) Blueprint for Action 2025-2030 Palliative Care Coalition of Canada (PCCC); 4/24/26 The Palliative Care Coalition of Canada (PCCC) released the Blueprint for Action 2025–2030, a national roadmap that identifies key priorities needed to ensure that more people in Canada have access to high-quality, culturally safer, and affordable palliative care. 

Palliative care loss hits Durango patients The Durango Herald, Durango, CO | Letters to the Editor; by Stacey Ebel; 4/24/26 My emotions are running high after learning about CommonSpirit Mercy Hospital discontinuing their palliative care program. ... My mother moved here in 2020 with numerous health issues, and I enrolled her in palliative care as I knew that at some point she would need to transition to hospice. Her palliative care nurse practitioner, Jen, visited my mother monthly in her apartment ...  Potential and past patients will now have to go to the ER or their personal PCPs for treatment. Recently, the last palliative care nurse had to discharge 200 patients. 

Second-generation antipsychotics for depression in serious illness: A first-line augmentation strategyJournal of Pain & Symptom Management; by Gregg Robbins-Welty, Mia Pattillo, Danielle Chammas, Karolina Sadowska, Cara L McDermott, Nneka Ufere, Jason A Webb, Daniel Shalev; 3/26Depression in serious illness is common, disabling, and often requires rapid improvement. In the psychiatric literature, SGA [second-generation antipsychotics] augmentation improves response and remission rates ... , with onset of improvement within 1-2 weeks. Monotherapy is less well tolerated and not guideline-recommended. No RCTs have evaluated SGAs specifically for depression in serious illness, but numerous cancer trials support their safety for nausea, appetite, and other symptoms. Despite the absence of serious illness-specific psychiatric trials, SGAs have the strongest evidence base among augmentation options and may offer meaningful benefits when prognosis or symptom severity necessitates rapid improvement. Low-dose augmentation should be considered early, rather than only after multiple failed antidepressants, particularly when SGAs can also target co-occurring physical symptoms relevant to palliative care.

Palliative care market: expanding healthcare focus on quality of life BriefingWire.com; Press Release; 4/23/26 Palliative Care Market is witnessing steady global growth due to the rising prevalence of chronic and life-limiting diseases such as cancer, cardiovascular disorders, respiratory illnesses, and neurodegenerative conditions. ... Technological advancements, such as telemedicine and remote patient monitoring, are further reshaping the palliative care landscape. These innovations allow healthcare providers to deliver continuous care to patients in remote or underserved areas, improving accessibility and reducing hospital dependency. Integration of digital health platforms is also enhancing coordination between multidisciplinary care teams, ensuring better patient outcomes.

End-of-life guidelines [in the ICU] emphasize unified care American Association of Critical-Care Nurses, in "Clinical Voices April 2026"; 4/21/26 New guidelines for end of life (EOL) care in the ICU call for clearer communication with families, stronger support for decision making and coordinated teamwork across disciplines to align treatments with what patients can realistically achieve and reduce suffering. “Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICU ,” in Critical Care Medicine, highlights the need for standardized processes, including identifying legal surrogates, using shared decision making tools and adopting protocolized withdrawal pathways. Additional priorities include early palliative care involvement, spiritual support and focused education to reduce conflict. Recommendations are summarized in three major areas: